Decentering, perspective broadening and anxiety

Section A
Theorists have long suggested that the process of decentering may be linked to anxiety. This paper reviewed empirical studies to explore what, if any, relationship existed between decentering and anxiety. A systematic search yielded 16 papers that met inclusion criteria. Studies included were a range of cross-sectional design with simple and multi-variant associations; longitudinal design; causal-comparative design; and intervention designs. The review found good evidence from studies of sufficient quality to the conclusion that there is a negative association between decentering and anxiety. Evidence was not found for further comment on the nature of the relationship. Research that directly targets decentering as an independent variable while measuring anxiety as the dependent variable is one of the recommendations of this review.

Section B
Anxiety presentations remain the most prevalent mental health condition and are associated with poor quality of life as well as an immense health care costs to the NHS. Transdiagnostic approaches that target the mechanisms of change in established therapies offer promise in developing briefer, more targeted interventions and have the potential to be applied across mental health presentations. The STAGE approach was developed as a two-step technique to directly target decentering and perspective broadening, hypothesised active ingredients of CBT and mindfulness therapies. This study sought to use a pilot and feasibility design to explore a new brief online self-help format of STAGE for those with self-reported anxiety. Overall, the STAGE programme was found to be mostly acceptable to participants. Additionally, trends and preliminary data were tentatively encouraging. However, attrition rates were considerable, and it was considered unfeasible to recruit and run a full-scale randomised control trial (RCT) without further adaptations to the STAGE format. Study limitations are discussed as are the implications for theory, research and clinical practice.